Scientific Poster Session III: Resident and Fellows Research-in-Progress

Residents and Fellows Research in Progress
  Monday, November 13, 2023
  01:00 PM–02:30 PM

Abstract

Introduction: Canada’s health sector’s carbon footprint is amongst the worst in the world, responsible for 4.6% of Canada’s total greenhouse gas emissions; a quarter of which are linked to pharmaceuticals including metered dose inhalers (MDIs).

Research Question or Hypothesis: Describe MDI prescribing, dispensing, usage and waste patterns at The Ottawa Hospital (TOH) and estimate the monetary and carbon cost of current practice and the potential benefits and costs of switching to the more environmentally friendly dry powder inhalers (DPI).

Study Design: Retrospective point-prevalence cohort study. Methods: 100 consecutive patients from medical and surgical services were identified from discharge reports, all prescribed one or more MDIs during their admission. Data was collected on demographics, MDI prescribing, dispensing, usage and wastage. The study cohort’s usage and waste data was applied to annual purchasing data to estimate annual usage and waste. Monetary cost was applied using local estimates while carbon cost was calculated using published estimates.

Results: 315 MDIs were dispensed in total, of which 96 were unused. 61440 actuations were dispensed, 56773 (92%) were unused or wasted. Waste data was applied to annual estimates, with a calculated carbon footprint of 315.8 tonnes of carbon dioxide equivalents (tCO2e). We estimate that a 20% waste reduction would result in a carbon savings of 68.5 tCO2e. If 20% of salbutamol prescriptions were switched to the dry powder inhaler alternative, terbutaline, a 14% reduction in waste would be required to offset the additional monetary cost.

Conclusion: This study suggests that 92% of MDI doses are unused and wasted. Many opportunities for waste reduction exist and would be associated with monetary savings that could be used to offset the cost of adding dry powder inhaler alternatives to formulary.

Presenting Author

Carolanne Caron BSc.Pharm
The Ottawa Hospital

Authors

Katherine Bateman BScPharm
The Ottawa Hospital

Salmaan Kanji PharmD
The Ottawa Hospital

Mathilde Gaudreau-Simard MD
The Ottawa Hospital

Smita Pakhale MD
The Ottawa Hospital

Owen Degenhardt BScPharm,
The Ottawa Hospital

Shellyza Sajwani MPharm, PharmD
The Ottawa Hospital